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Abstract：
BACKGROUND: The os trigonum (OT)-the most common accessory bone of the foot-although usually asymptomatic, may cause posterior ankle impingement syndrome (PAIS), which may be a severely debilitating problem for recreational or competitive athletes. The aim of the present study was to evaluate effectiveness of posterior ankle arthroscopy and to assess the outcome in the treatment of PAIS secondary to OT impingement or OT fractures within a group of young athletes and their return to previous sports level.
METHODS: From 2011 to 2018, a retrospective review of 81 recreational athletes of mean age 27.8 years was performed. All patients were diagnosed with PAIS due to OT pathology and were operated on endoscopically with resection of the OT. Pre- and postoperative clinical evaluation were performed at 3 months, 1 year, and 2 years based on visual analog scale (VAS), ankle range of motion (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, and the Foot & Ankle Disability Index (FADI) scores, in a follow-up of at least 2 years.
RESULTS: VAS score was significantly improved from an average of 7.5 (5-9) preoperatively to 1.9 (1-3) at 3 months postoperatively and to 0.6 (0-2) and 0.3 (0 -1) at 1 and 2 years postoperatively. Ankle ROM was significantly improved from an average of 24.8 (10-35) preoperatively to 58.0 (50-65) at 3 months postoperatively and to 64.0 (50-65) at 1 year and 64.7 (60-65) at 2 years postoperatively. AOFAS and FADI scores were significantly improved from 39.4 (18-55) and 49.7 (42.3-62.5) preoperatively to 85.2 (74-89) and 87.3 (81.7-88.5) postoperatively at 3 months to 97.7 (85-100) and 97.9 (93.3-100) postoperatively at 1 year, respectively (P < .001). Only 5 patients dropped to a lower activity level. There were 5 complications (4 transient).
CONCLUSIONS: Endoscopic treatment of PAIS due to OT pathology demonstrated excellent results. Posterior ankle arthroscopy was an effective treatment and allowed for a prompt return to a high activity level of their athletic performance.
METHODS: Level IV, therapeutic study / retrospective case series.
METHODS: From 2011 to 2018, a retrospective review of 81 recreational athletes of mean age 27.8 years was performed. All patients were diagnosed with PAIS due to OT pathology and were operated on endoscopically with resection of the OT. Pre- and postoperative clinical evaluation were performed at 3 months, 1 year, and 2 years based on visual analog scale (VAS), ankle range of motion (ROM), American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score, and the Foot & Ankle Disability Index (FADI) scores, in a follow-up of at least 2 years.
RESULTS: VAS score was significantly improved from an average of 7.5 (5-9) preoperatively to 1.9 (1-3) at 3 months postoperatively and to 0.6 (0-2) and 0.3 (0 -1) at 1 and 2 years postoperatively. Ankle ROM was significantly improved from an average of 24.8 (10-35) preoperatively to 58.0 (50-65) at 3 months postoperatively and to 64.0 (50-65) at 1 year and 64.7 (60-65) at 2 years postoperatively. AOFAS and FADI scores were significantly improved from 39.4 (18-55) and 49.7 (42.3-62.5) preoperatively to 85.2 (74-89) and 87.3 (81.7-88.5) postoperatively at 3 months to 97.7 (85-100) and 97.9 (93.3-100) postoperatively at 1 year, respectively (P < .001). Only 5 patients dropped to a lower activity level. There were 5 complications (4 transient).
CONCLUSIONS: Endoscopic treatment of PAIS due to OT pathology demonstrated excellent results. Posterior ankle arthroscopy was an effective treatment and allowed for a prompt return to a high activity level of their athletic performance.
METHODS: Level IV, therapeutic study / retrospective case series.
摘要：
背景：三角骨（OT）-足部最常见的副骨-尽管通常无症状，可能导致后踝关节撞击综合征（PAIS），对于娱乐或竞技运动员来说，这可能是一个严重的衰弱问题。本研究的目的是评估后踝关节镜的有效性，并评估一组年轻运动员中OT撞击或OT骨折继发PAIS的治疗结果及其恢复到以前的运动水平。
方法：从2011年到2018年，对81名平均年龄27.8岁的休闲运动员进行了回顾性研究。所有患者均因OT病理诊断为PAIS，并在内镜下切除OT。术前、术后3个月进行临床评估,1年,和基于视觉模拟量表(VAS)的2年，踝关节运动范围（ROM），美国骨科足踝协会（AOFAS）后足评分，和足踝残疾指数(FADI)评分，在至少2年的随访中。
结果：VAS评分从术前的平均7.5（5-9）到术后3个月的1.9（1-3），以及术后1年和2年的0.6（0-2）和0.3（0-1）。踝关节ROM从术前平均24.8（10-35）到术后3个月的58.0（50-65），1年至64.0（50-65），术后2年至64.7（60-65）。AOFAS和FADI评分从术前的39.4（18-55）和49.7（42.3-62.5）到术后3个月的85.2（74-89）和87.3（81.7-88.5）显着改善，术后1年的97.7（85-100）和97.9（93.3-100），分别(P<.001)。只有5名患者下降到较低的活动水平。有5个并发症（4个一过性）。
结论：内镜治疗因OT病理引起的PAIS具有良好的效果。后踝关节镜检查是一种有效的治疗方法，可以迅速恢复其运动表现的高活动水平。
方法：四级，治疗性研究/回顾性病例系列。
方法：从2011年到2018年，对81名平均年龄27.8岁的休闲运动员进行了回顾性研究。所有患者均因OT病理诊断为PAIS，并在内镜下切除OT。术前、术后3个月进行临床评估,1年,和基于视觉模拟量表(VAS)的2年，踝关节运动范围（ROM），美国骨科足踝协会（AOFAS）后足评分，和足踝残疾指数(FADI)评分，在至少2年的随访中。
结果：VAS评分从术前的平均7.5（5-9）到术后3个月的1.9（1-3），以及术后1年和2年的0.6（0-2）和0.3（0-1）。踝关节ROM从术前平均24.8（10-35）到术后3个月的58.0（50-65），1年至64.0（50-65），术后2年至64.7（60-65）。AOFAS和FADI评分从术前的39.4（18-55）和49.7（42.3-62.5）到术后3个月的85.2（74-89）和87.3（81.7-88.5）显着改善，术后1年的97.7（85-100）和97.9（93.3-100），分别(P<.001)。只有5名患者下降到较低的活动水平。有5个并发症（4个一过性）。
结论：内镜治疗因OT病理引起的PAIS具有良好的效果。后踝关节镜检查是一种有效的治疗方法，可以迅速恢复其运动表现的高活动水平。
方法：四级，治疗性研究/回顾性病例系列。
